After-Hours Phone Consultation Communication Error-Prone

Physicians and nurses on after-hours phone consultations may experience significant decision-making and communication problems, according to an article published in the British Medical Journal for Quality and Safety.

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Researchers simulated more than 100 after-hours conversations among nurses and physicians, including situational cues in the calls based on common reasons for after-hours phone calls. Each cue had a rubric of various possible actions a physician might take to follow up.

Situational cues describing a patient’s problem elicited physician action 57 percent of the time, while background cues describing a specific clinical cause of the patient’s problem elicited action 48 percent of the time. When only situational cues were provided, physicians followed up by asking for background cues only 12 percent of the time.

The study concludes patient safety could benefit from a focus on improving the quality of after-hours phone consultations.

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